A rapid blood test that can distinguish heart attack in people presenting at emergency departments (EDs) with chest pain has been developed by researchers.
The research team from Haukeland University Hospital in Bergen, Norway, presented their findings in a Hot Line Session at ESC Congress 2024 held in London from August 30 to September 2.
The test requires one drop of blood and can be performed at the point of care (POC), with results in eight minutes, the researchers said. Current testing to determine whether a patient presenting with chest pain has acute coronary syndrome (ACS) is performed at a central lab using two blood samples taken at presentation and one to three hours later, with a turnaround time of approximately 60 minutes.
Chest pain is one of the most common causes globally for hospitalization; however, between 60% and 70% of patients who are admitted are determined to have a benign source for the pain. Ruling out or ruling in ACS with a POC rapid test could lead to faster treatment and better outcomes for patients. Additionally, faster diagnosis may also lead to shorter hospital visits and stays, mitigating the dangerous overcrowding of EDs.
In the study, 1,494 consecutive adult patients with chest pain symptoms suggesting ACS presenting to the ED at Haukeland University Hospital from March 2022 to March 2024 were randomized to either the new test with a turnaround time of eight minutes (728 patients) or standard testing (766 patients). The patient characteristics were similar between the groups; the cohort had a median age of 61 and 43% were women. The patients were subsequently admitted or discharged based on the attending physician's judgment.
The researchers found that the average length of stay in the ED was 174 minutes for the POC testing group compared to 180 minutes in the standard testing group. However, when patients were seen within 60 minutes, POC testing reduced the length of the ED stay by 15 minutes (147 minutes for the POC group; 162 minutes for the standard testing group).
Patients diagnosed with non-ST-elevation myocardial infarction had their ED stays shortened considerably with the POC test (137 minutes as opposed to 180 minutes) prior to admission to the cardiac ward.
Moreover, both testing types showed comparable high safety and reliability, with very few patients experiencing events after being discharged.
"POC troponin assays hold great promise to improve patient care. But our findings underscore the need for a process to map out and address obstacles to efficient patient flow, such as lack of relevant staff or lack of efficient discharge procedures, to realize the full potential of POC tests to manage chest pain patients in the emergency department," lead author Dr. Kristin Aakre said.
"Future research should focus on the utility and implementations of these tools in out of hospital settings like ambulances and primary care emergency care clinics or offices."
